Dd was jaundice and was under the bill lights within 12 hours of birth (due to a blood incompatibility). She could only cone out every 4 hours to nurse for 20 mins. After she nursed I pumped for an additional 20 minutes and anything I got from pumping she was given in a syringe. We were told to top off with formula. She immediate spit the formula back out and the nurse cheered for her. We didn't really try to push the formula but were really good about keeping her under the lights and using the bili blanket when she nursed. We would rather do that than formula if avoidable. But if it wasn't working, we would have pushed the formula.

It is stories like these that always make me wonder. I was very fortunate to have been able to EBF each of my children, even my middle who wore a biliblanket and I had to pump while I was back at the hospital with a spinal headache. But, I never felt like it was a contest and often I read posts where it seems like people feel it is. Yay - I was crying and so exhausted that I was in bed at 6 and my mother and DH had to take care of my newborn for me -- but he never got formula. I don't think I would have made that trade off.

I think that you are mistaking one mother being proud of her hard work for competing with others. Who was she competing with? No one. She was trying to do the best for her baby. It's been proven time and again, if you care about studies, and I know that you do, that exclusive breastfeeding is the best for most babies. Not just breastfeeding, but NO formula. Many people don't believe that, or there wouldn't be so many moms feeding their babies formula right now. The mom who you referenced beleived it so much that despite troubles, she refused to take what probably would have been the easy way out, and she is PROUD of the effort that she put forth. And she is probably sharing for anyone else's benefit who might not believe that it is possible. So why accuse her of competing? You're bringing her, and her accomplishment, down to a level that YOU feel more comfortable with.

Elevated levels of bilirubin can be very dangerous. High enough levels for long enough can cause permanent neurological damage. Jaundice needs to be taken very seriously for the ultimate health of the child.

Babies with jaundice become very sleepy as a result. This means that they often are very poor nursers. Keeping them awake long enough to get sufficient breastmilk in those early days can be very tough to do. Breastmilk is also digested more fully than formula which means that those babies often have fewer and smaller bowel movements than babies on formula which means that formula fed babies generally clear the bilirubin from their bodies more quickly than breastfed babies (which is good for baby). Latch problems can be common and part of the reason is that baby is too sleepy to get and keep a good latch. Pumping can be an alternative that works for a lot of people. I addition, sunlight or biliblankets help breakdown the bilirubin so that it can be excreted.

Switching to formula is fairly standard advice because of how dangerous longterm exposure to high levels of bilirubin can be. It is absolutely possible to breastfeed your way through jaundice and for baby to be fine. But, please don't just dismiss the advice as bad advice.

My middle child had a borderline bili level when we left the hospital. We went to the doctor about 36 hours later and his level was higher. We were advised to get him in the sun and nurse as much as possible (or supplement). His levels continued to rise for the next day or two and ultimately we had to use a biliblanket on him 24/7 at home for 5 days with a visiting nurse coming in daily to do a heel stick to check his levels. We got through it without supplementing. However, it was something that we continually reevaluated because if my milk hadn't come in quickly and if we couldn't keep him awake enough to nurse or he wasn't having enough bm's, then we knew that supplementing may well be more important for his longterm health than exclusively breastfeeding. We were careful to stick with advice from our doctor, LC and the information we received from daily bili level information. It isn't necessarily bad advice that she is getting and certainly shouldn't just be blown off as an ignorant doctor.

This is avery good post. I completely agree.

My first DS1 had very high billi levels. So high we barley avoided the NICU and he was on the bili blanket at home and we were at the hospital everyother day to have his levels check. We did BF and a small amout of fomula after I nursed for two weeks. Then he was done with formula and didn't have anymore.

DD had high bili levels but not as high as DS1 but it was a struggle the first two weeks to get her to stay awake long enough to nurse. She was sooo sleepy and would only nurse for a short time.

__________________
wife and mom-- no other special labels. Just trying to do the best I can.

This is so true, I was railroaded by jaundice. I breastfed my daughter for 3 weeks because I was told by everyone to formula feed her, so one day I gave in and stopped. Also, I couldn't get her to latch on. Even my husband was saying to give her formula and so I stopped. So mad at giving up, even went so far as getting bad post-partum over it.

I think that you are mistaking one mother being proud of her hard work for competing with others. Who was she competing with? No one. She was trying to do the best for her baby. It's been proven time and again, if you care about studies, and I know that you do, that exclusive breastfeeding is the best for most babies. Not just breastfeeding, but NO formula. Many people don't believe that, or there wouldn't be so many moms feeding their babies formula right now. The mom who you referenced beleived it so much that despite troubles, she refused to take what probably would have been the easy way out, and she is PROUD of the effort that she put forth. And she is probably sharing for anyone else's benefit who might not believe that it is possible. So why accuse her of competing? You're bringing her, and her accomplishment, down to a level that YOU feel more comfortable with.

I am sure she is proud. That's great. But, as I said - the tradeoff if likely not one I would have made personally.

I agree with you that exclusive breastfeeding is best for most babies. Yup, I agree.

But, the description of a baby who needed biliblanket treatment for 2+ weeks (that is a long time to have a high bili level), couldn't latch on well to the point where mom was pumping with each feeding, and apprently from the sound of her post - physically and emotionally exhausted may have been a child who would have benefited from some formula. She was already bottle feeding and formula often helps babies get rid of bilirubin more quickly. My personal concern would have been with the high bili levels and preventing neuro deficits in the future - not a couple of hundred ounces of formula.

We all make our own decision. I came to this thread to point out to the OP that doctors aren't simply being ignorant in suggesting supplementing a baby with a high bili level (high enough that baby is returning to the hospital). But, that there are cases where formula can be beneficial to babies with serious jaundice.

Almost all my babies have had jaundice at some point, some worse than others. My 4th seemed to have the prolonged breastmilk jaundice and had Bili lights and daily level checks. I was told to supplement with formula for 4 days but not given or told to pump and freeze the milk and get him nursing ASAP after. So obviously that messed everything up and he ended up on formula for good. My 2nd was under lights for a couple days as well, my other 4 didn't need lights, but had it. I had it as well but my mom was told to have me in front of the window in my bassinet.

It is stories like these that always make me wonder. I was very fortunate to have been able to EBF each of my children, even my middle who wore a biliblanket and I had to pump while I was back at the hospital with a spinal headache. But, I never felt like it was a contest and often I read posts where it seems like people feel it is. Yay - I was crying and so exhausted that I was in bed at 6 and my mother and DH had to take care of my newborn for me -- but he never got formula. I don't think I would have made that trade off.

A contest?? I was a brand new mom who needed my husband's help AND my mom's help around the clock to take care of my baby. If there was any sort of "competition", I wouldn't have even been in the running.
My mom started "supplementing" with me and my brother when we were babies and only nursed 6 and 4 months, respectively. Any friends that I have that have "supplemented" with formula have 100% of the time ended up with completely formula fed babes. (I'm sure statistics are different - that is just my experience.)
My *personal* goal for my child was that he would be exclusively breast fed. I knew adding formula into his diet that early could quickly turn into a road block to a healthy nursing relationship because 1) a bottle is easier for the baby, 2) it's tempting to fall back on it since baby sleeps longer, fusses less, etc., 3) it is difficult to get and maintain a proper supply when your body isn't getting full demand from the baby. Among many, many others! But those were just my main reasons.
It wasn't a competition, it was just something I felt very strongly about and something I WAS going to do no matter what. Feeling frustrated over latch issues (which turned out to be a severe tongue tie) and frustrated because I was exhausted (which I would have been anyway!) were small potatoes compared to the guilt and frustration I would have felt if I could not - or did not - provide the best possible nutrition for my child.
Oh, and his bili levels were never even close to high enough for brain damage to be a concern. They were high enough to not warrant going unaddressed. I would not have put my child in danger over exclusive breastfeeding.

ETA: I was not pumping because he wasn't getting enough during a session. I was pumping to supplement with bm *instead* of supplementing with formula to flush out the bilirubin. Just like formula wouldn't replace entire feedings, he never got a full feeding from a bottle - he just got whatever he would take from a bottle after he was too tired/frustrated to nurse any more.

Quote:

Originally Posted by DesertRat

I totally understand what you're saying. But to some degree, I think breastfeeding moms almost have to have this "do or die" mentality about breastfeeding. The first few weeks are really hard. It's going to be so tempting to give in and give a bottle, or whatever. But I don't think enough moms realize that a) it gets easier after a few weeks and that b) every bottle the baby gets has the potential to adversely affect breastfeeding. I know so many women who sincerely wanted to breastfeed but who didn't realize that some of the choices they made in the first few days/weeks set them up for failure.

Well said! You are exactly right. Yes, he was technically getting a bottle anyway, but I wasn't shocking his digestive system by radically changing what he was consuming. I knew that with every bottle of formula he would potentially consume, that would make EBF THAT much more difficult. I joke that those first few weeks with DS were SERE training for mommies, but looking back, it was a small price to pay for an amazing nursing relationship that lasted 17 months (and now my pregnant hormonal self is crying because he stopped! Haha).
I saw it with my mother and with other women - they had a sincere desire to breastfeed, or at least wanted to give it a good go, but ended up falling back on formula for whatever reason, and it took over. Formula was not an OPTION for us - I didn't walk down that aisle at the store, I didn't talk about it, I didn't let it come in the house, etc. If formula was an option, then breastfeeding was, too. And in my eyes, if my body is capable (which it was/is), feeding my child the way God designed me to was not an option, and I'm so glad I approached it that way. It's just what worked for us.

Quote:

Originally Posted by songbird516

I think that you are mistaking one mother being proud of her hard work for competing with others. Who was she competing with? No one. She was trying to do the best for her baby. It's been proven time and again, if you care about studies, and I know that you do, that exclusive breastfeeding is the best for most babies. Not just breastfeeding, but NO formula. Many people don't believe that, or there wouldn't be so many moms feeding their babies formula right now. The mom who you referenced beleived it so much that despite troubles, she refused to take what probably would have been the easy way out, and she is PROUD of the effort that she put forth. And she is probably sharing for anyone else's benefit who might not believe that it is possible. So why accuse her of competing? You're bringing her, and her accomplishment, down to a level that YOU feel more comfortable with.

Thanks, mama. <3

Quote:

Originally Posted by TwinKristi

Almost all my babies have had jaundice at some point, some worse than others. My 4th seemed to have the prolonged breastmilk jaundice and had Bili lights and daily level checks. I was told to supplement with formula for 4 days but not given or told to pump and freeze the milk and get him nursing ASAP after. So obviously that messed everything up and he ended up on formula for good. My 2nd was under lights for a couple days as well, my other 4 didn't need lights, but had it. I had it as well but my mom was told to have me in front of the window in my bassinet.

See, this is what upsets me. I'm thoroughly convinced this would have been us had I not said to our ped the first chance I got - absolutely not, formula isn't an option, not a drop. She had to figure out an "alternate route" for me to bring my child back to optimal health. I had to nurse and pump around the clock, so I did. It frustrates me that women have to fight for BFing advocacy and educate *themselves* on BFing and that both of those things are not offered freely because we are such a formula -inundated and -accepting culture.

Ds had horrid jaundice. He was almost hospitalized for it - he was a 1/2 point away from being sent to the hosp. He was on bili lights for close to 2 weeks. Our pedi said that supplimenting a little formula each day actually didn't help any. He said as a last resort we would have to go to 100% formula for 3 days. He said in very rare cases breast milk makes jaundice worse and you need to flush the system with formula but in that case you need to stop all breastmilk. He said if we got to that stage I'd pump to keep my milk up and he'd have us work with a LC to get him back on the breast. We never got to that stage a just got close enough for our pedi to talk about it because even on the lights it took a couple days for ds's levels to start slowly dropping.

He said breastmilk makes flushing jaundice out of the system go slower than formula but that hardly a reason to do formula - just meant daily blood draws for awhile to make sure it wasn't getting too high. (and ds was born right in the middle of the h1n1 stuff so I hated taking him to the clinic daily)

Some of these posts are really frustrating to read. Breastfeeding mothers need to be supported. It's hard enough without being told your milk isn't good enough. Yes, jaundice can be serious. There is no set number for how high is too high. Newer studies are showing that it may not be as dangerous as previously thought, but they aren't yet conclusive. Right now treatment is determined from a graph based on gestational age, hours/days old and bili level. A 2 day old full term baby can tolerate higher bili levels than a 18 hour old 37 weeker. Seriously high bili levels (>20) are rare. A baby discharged home on a bili blanket does not have seriously high levels. Bili blankets do not provide the same levels of phototherapy as larger lights but are better than sunlight alone.

Supplementing with formula should not be the first treatment. This is the easy answer for the doctor, nurse and mother. Part of breastfeeding is dedication on the mother's part. I've worked with all kinds of moms from those who can and will do anything to succeed to those who have literally taken one look at the baby, decided they are too exhausted from birth, and chosen to bottle feed after all. I don't always agree with what a mother chooses, but I do respect her right to choose. Her body, her baby. Studies do show that even one formula feeding permanently changes a baby's gut flora. A mother that insists on no formula has the facts to back up her choice.

Colostrum is actually a laxative and works wonderfully for baby to clear meconium stools. Time at breast should never be limited. A baby can be nursed with a bili blanket in place. Jaundiced babies are sleepy babies who don't nurse well. First choice of supplement should be mothers own milk! Bottle nipples are not necessarily the answer either. A mother can express by hand and spoon or cup feed her baby. This requires less energy than bottle feeding. She can also pump her her milk to supplement with. Baby can be supplemented at breast to encourage a stronger suck.

Sorry for the rambling post. I'm a maternity RN and IBCLC. I've had 4 jaundiced babies including 1 nearly transferred to NICU for a blood transfusion and preterm twins.

__________________

Jenn, happily married to 10/96,
mom to 12/01, and 3/04,
momma again to 1/10, and a new baby 3/13

Some of these posts are really frustrating to read. Breastfeeding mothers need to be supported. It's hard enough without being told your milk isn't good enough. Yes, jaundice can be serious. There is no set number for how high is too high. Newer studies are showing that it may not be as dangerous as previously thought, but they aren't yet conclusive. Right now treatment is determined from a graph based on gestational age, hours/days old and bili level. A 2 day old full term baby can tolerate higher bili levels than a 18 hour old 37 weeker. Seriously high bili levels (>20) are rare. A baby discharged home on a bili blanket does not have seriously high levels. Bili blankets do not provide the same levels of phototherapy as larger lights but are better than sunlight alone.

Supplementing with formula should not be the first treatment. This is the easy answer for the doctor, nurse and mother. Part of breastfeeding is dedication on the mother's part. I've worked with all kinds of moms from those who can and will do anything to succeed to those who have literally taken one look at the baby, decided they are too exhausted from birth, and chosen to bottle feed after all. I don't always agree with what a mother chooses, but I do respect her right to choose. Her body, her baby. Studies do show that even one formula feeding permanently changes a baby's gut flora. A mother that insists on no formula has the facts to back up her choice.

Colostrum is actually a laxative and works wonderfully for baby to clear meconium stools. Time at breast should never be limited. A baby can be nursed with a bili blanket in place. Jaundiced babies are sleepy babies who don't nurse well. First choice of supplement should be mothers own milk! Bottle nipples are not necessarily the answer either. A mother can express by hand and spoon or cup feed her baby. This requires less energy than bottle feeding. She can also pump her her milk to supplement with. Baby can be supplemented at breast to encourage a stronger suck.

Sorry for the rambling post. I'm a maternity RN and IBCLC. I've had 4 jaundiced babies including 1 nearly transferred to NICU for a blood transfusion and preterm twins.